Written by Dennis Thompson
WEDNESDAY, November 9, 2022 (HealthDay News) — The opioid epidemic in the United States has been heartbreaking — literally.
A new study reports that the risk of young adults dying from a devastating heart infection has tripled in the United States over the past two decades.
Researchers attribute the increase in fatal heart infections to the increasing number of people between the ages of 15 and 44 who use opioid drugs.
“We found that people who inject drugs account for a greater percentage of deaths from infective endocarditis, compared to 20 years ago,” said lead researcher Dr.
“This is more noticeable among young people,” he added.
Endocarditis occurs when the lining of the heart valves and heart chambers – the endocardium – becomes infected with germs, usually bacteria, that enter the bloodstream.
If left untreated, it can “destroy the heart,” said Dr. Georgios Syros, director of arrhythmia services at Mount Sinai Queens in New York City.
“You could have strokes. You could have leaky valves. You may have to have open-heart surgery to replace those valves,” Cirrus said. “It’s devastating.”
The death rate from infective endocarditis in people ages 15 to 44 doubled between 1999 and 2020, rising from 0.3 deaths to 0.6 deaths per 100,000 people, according to researchers’ analysis of federal mortality data.
Even worse, the results showed that the death rate from endocarditis tripled for people aged 15 to 34, rising from 0.1 to 0.3 deaths per 100,000 people.
This happened even as the death rate from endocarditis for the entire US population declined, from 2.1 per 100,000 people in 1999 to 1.8 in 2020.
Overall, young adults accounted for 10% of all deaths from endocarditis in 2020, up from less than 7% in 1999, the researchers found.
Looking at the statistics closely, the research team concluded that the opioid epidemic is likely responsible for the higher endocarditis deaths among young adults.
People who inject drugs make up a growing percentage of all who die of endocarditis, rising from 1.1% in 1999 to 3% in 2020.
Among young adults, intravenous drug users accounted for nearly 20% of endocarditis deaths in 2020, up from about 10% in 1999, according to the report.
“This is a continuation of the story of death by despair that we saw. It is unfortunate that these data and findings confirm what we have been seeing clinically for years,” said Dr. Wael Jaber, MD, a cardiologist at the Cleveland Clinic in Ohio.
Cyrus and Campactis said humans have layers upon layers of skin and immune defenses to keep germs from circulating freely in the bloodstream, but drug users who shoot bypass all that protection.
“Intravenous injection can transfer bacteria directly into the circulation,” Campactis explained. Bacteria can be found in the skin or needles. Once the needle is in the vein, it allows bacteria to enter the circulation and travel to the heart.”
Cyrus added that the risk is greater because drug users often inject themselves regularly.
“These guys did break through the barrier repeatedly,” Cyrus said. “They don’t inject once in a lifetime. They inject permanently, and they also share needles. This doubles the risk of being exposed to something that can cause infective endocarditis.”
Experts said treatment options are limited, and usually involve large doses of intravenous antibiotics.
“Sterilization of the bloodstream is often difficult and the risk of reinfection is high, especially with continued drug use,” Jaber said.
He noted that if the infection has damaged the heart valves, high-risk open-heart surgery may be needed to replace them with artificial valves.
“There is really no good way” to treat “this heart complication,” Jaber said.
Syros said needle exchange programs are probably the only way to immediately address this risk to heart health.
“We should definitely try to give them clean syringes,” Cyrus said. “If you want to use, please use a clean syringe.”
Cyrus added that substance use rose during the COVID pandemic, with fatal drug overdoses increasing by nearly 30% during the first full year of the crisis.
“This is something I personally witnessed in the hospital,” Cyrus said. “There were people swirling there – before the pandemic, they were about to use/not use drugs, drink alcohol/not drink alcohol. Because of the pandemic, it was a slap, and then we saw numbers go up very, very, very quickly.”
Until the United States adopts cultural and political changes to effectively reduce opioid use, Cyrus believes cases of endocarditis among young drug users will continue to rise.
“I think we will see a boom in the coming years, following the increase in the number of people taking opioids during COVID,” Cyrus said. I think there will be a wave of young endocarditis in the years after the epidemic. will rise.”
The new study was published November 9 in Journal of Internal Medicine.
The Cleveland Clinic offers more about endocarditis.
SOURCES: Polydoros Kampaktsis, MD, PhD, assistant professor, Department of Cardiology, Columbia University, Irving Medical Center, New York City; Georgios Syros, MD, director, Arrhythmia Services, Mount Sinai Queens, New York City; Wael Jaber, cardiologist, Cleveland Clinic, Ohio; Journal of Internal MedicineNovember 9, 2022